The pCONus Device in Treatment of Wide-necked Aneurysms : Technical and Midterm Clinical and Angiographic Results

Clin Neuroradiol. 2018 Mar;28(1):47-54. doi: 10.1007/s00062-016-0542-z. Epub 2016 Sep 16.

Abstract

Purpose: A variety of devices for treatment of wide-necked bifurcation aneurysms are emerging. Here we report our results using the new pCONus device with special emphasis on the morphological and anatomical requirements for successful implantation.

Methods: In this study we treated 21 patients with 22 aneurysms by endovascular interventions. After providing informed consent, patients were included according to the following criteria: aneurysm dome to neck ratio <2 or neck diameter >4 mm. The primary end points for clinical safety were the absence of death, absence of major or minor stroke and absence of transient ischemic attack.

Results: A total of 22 aneurysms in 21 patients were treated with pCONus-assisted coiling. In 19 patients harboring 20 aneurysms the implantation of the device was successful and these aneurysms showed an adequate occlusion after 6 months in 95 %. The complication rate was low (5 %) with one case of minor neurological stroke. Analysis of the data showed that the difference in aneurysm angulation between successful (mean 45°) and failed implantations (mean 71.5°) was highly significant.

Conclusion: Use of the pCONus device and coiling in wide-necked bifurcation aneurysms is safe and provides good occlusion rates but might be limited by the angulation between the aneurysm and the parent vessel.

Keywords: Aneurysm; Bifurcation; Coiling; Device; Stent.

MeSH terms

  • Adult
  • Aged
  • Cerebral Angiography
  • Embolization, Therapeutic*
  • Germany
  • Humans
  • Intracranial Aneurysm / diagnostic imaging
  • Intracranial Aneurysm / therapy*
  • Middle Aged
  • Prospective Studies
  • Retrospective Studies
  • Stents
  • Treatment Outcome